NPI | 1295075356 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 16292) |
Additional Taxonomies | 101Y00000X Counselor (Licence: TX 16292) |
101YM0800X Counselor, Mental Health (Licence: TX 16292) | |
Enumeration Date | 2013-02-26 |
Last Update Date | 2015-02-26 |